Advance Directives FAQs

As a competent adult, you have the right to decide to accept or refuse any medical treatment. “Competent” means you understand your condition and the results your decisions may have. As long as you are competent, you are the only person who can decide what medical treatment you want and do not want to receive. Your doctors will give you information and advice about the pros and cons of different kinds of treatment, but only you can choose whether to say “yes” or “no.” You can say “no” even if the treatment you refuse might keep you alive longer and even if your doctor or your family wants you to have it.

Following are answers to frequently asked questions about advance directives. Download this FAQ in español.

Advance directives are documents signed by a competent person giving direction to health care providers about treatment choices in certain circumstances. There are two types of advance directives. A Durable Power of Attorney for Health Care allows you to name a “patient advocate” to act for you and carry out your wishes. A Living Will allows you to state your wishes in writing, but does not name a patient advocate. At Allegiance Health, we can provide you with the Durable Power of Attorney for Health Care for you to complete.
Many people have preferences for the kind of medical care they would like to receive or refuse in certain circumstances. An advance directive allows you to state your preferences.
  • Who would you like to make treatment decisions for you, if you become unable to do so?
  • How do you feel about ventilators, surgery, resuscitation (CPR), dialysis, or tube feeding if you were to become terminally ill? If you were unconscious and not likely to wake up? If you had dementia/Alzheimer’s Disease?
  • What kind of medical treatment would you want if you had a severe stroke or other medical condition that made you dependant on others for all your care?
  • What sort of mental, physical, or social abilities are important for you to enjoy living?
  • Do you want to receive every treatment your caregivers recommend?
It is a legal document that allows you to name anyone at least eighteen years old to be your advocate and make health care decisions for you. You can pick a family member, friend or any other person you trust, but be sure the person you choose is willing to serve. This document can be used to give instructions about treatment you would accept or refuse. If you want your patient advocate to be able to refuse any treatment and let you die, you must say so specifically in this document. A Durable Power of Attorney for Health Care goes into effect only when you are not able to make decisions for yourself as confirmed by two doctors or one doctor and one psychologist.
No. Although this is an option, no one can require you to have a Durable Power of Attorney for Health Care. You can make your wishes known by talking with your family or doctor or by writing them down, but unless you have this document, a patient advocate does not have legal authority to act for you. Must you give written instructions about your treatment? No. You can simply name a patient advocate. But, remember that your advocate can only have life-sustaining care stopped if you say so in a Durable Power of Attorney for Health Care. It is probably better to have written instructions because then everyone can read them and understand your wishes. If you do not want to name an advocate, you can write a “living will” stating your choices. Even though there is not a Living Will law in Michigan, courts and health care providers still find these documents useful because they show your choices for care. Or, you can simply make sure your family and caregivers know what you want if you were to get sick. It is important for hospitals to understand your wishes. Writing them down makes it clear what you want.
No. You do not have to have a Durable Power of Attorney for Health Care or Living Will and you do not have to tell anyone your wishes. You can still make treatment choices while you are competent. If you are no longer competent, but you have made sure your family and caregivers know what you would want, it will be easier to follow your wishes. If you have not made your wishes known to family and caregivers, a court may have to name a guardian to make decisions for you.
You can obtain a form from the Registration Office or Patient Support Services at Allegiance Health or ask your nurse to print a copy from the Health System Intranet. Forms are also available from the State Bar of Michigan, the Michigan State Medical Society, your state representative and senior citizen groups.
Legal advice is not required, but if you wish, your attorney can also help you prepare a document. You should talk to the person you have chosen to be your advocate to make sure that individual understands your wishes and is willing to act as your advocate. We also urge you to discuss your wishes with your family, friends, and health care team. By law, your family, physicians and employees of your health care facility are not allowed to be witnesses for this document.
Yes. You can change the document at any time. It is a good idea to review this document at least once a year and when you have a change in health to be sure it still says how you want to be treated and names an advocate you trust.

Our hospital policies provide that only the competent patient, not friends or family, can make health care decisions. If you are not able to make decisions, we first seek instructions from the patient advocate named in your Durable Power of Attorney for Health Care document. If you have not written an advance directive, we try to determine your wishes by reviewing any statements, oral or written, you have made. We have discussions with your family about what your wishes would be and how best to fulfill them. If we are sure about what you would want, we attempt to follow your wishes. If we do not know or are not sure about what you want, or if there is a disagreement about whether to treat you or not, we will continue to provide care, although we may have to ask a court to appoint a guardian to make decisions for you. We want to understand and carry out your choices for health care.

Treatment decisions are difficult. We encourage you to think about your wishes in advance, discuss your options with your family, friends, and health care professionals, and make plans for your future health care needs.

 

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